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 Judy Woodruff:
The surge of COVID cases in Idaho has gotten so bad that some
hospitals in the northern part of the state are having to ration the
care they give.

Idaho has one of the nation's lowest vaccination rates. Only 40

percent of the population is fully vaccinated.

As William Brangham tells us, many of the ICUs have been

pushed to their limits.
 William Brangham:
Judy, the decision by state officials to allow for the rationing of
care means that, if hospitals are so overtaxed, they can decide
to limit ICU rooms to just those patients who are most likely to
survive, and then move other patients to non-hospital rooms for
their care.

Elective surgeries have also been canceled or seriously cut

back. And these problems seem to be accelerating elsewhere in
the state. COVID cases are up more than 40 percent in the last
two weeks, and hospitalizations up 25 percent.

Brian Whitlock is the CEO of the Idaho Hospital Association. All

of the state's full-service hospitals are members of the
organization. And he joins me now from Boise.

Brian Whitlock, great to have you.

I'm sort of alarmed to hear what's going on in your state right

now. Can you just give us a sense of what you're hearing from
different hospital officials?
 Brian Whitlock, CEO, Idaho Hospital Association:
Thanks, William. I appreciate the opportunity.
 Our hospitals all across the state have been stressed for a
couple of weeks. What we saw starting at the beginning of
August was just a rapid increase in the number of positive cases,
which translated into hospitalizations, which translated into ICU
visits and also an increase in the amount of COVID deaths.

So that's been concerning since the beginning of August, and we

have been doing all that we can to prepare, to move into
contingency modes, to move hospital space into nontraditional
spaces like classrooms, hallways and other areas, where we can
at least try to meet the demand that's coming through the doors.
But we have reached the point where we are almost on overload
and have an inability to transfer patients to other areas of the
state or even the region because of the lack of capacity around
the state.
 William Brangham:
When people hear terms like rationing or crisis standards of
care, they are troubling sounding terms.

In a practical sense, if I'm a patient who's been in an ICU for a

while or I'm a patient who's arriving at an ICU, what does that
mean for me?
 Brian Whitlock:
It means that there may be a longer wait if you are just arriving.

I had a sobering conversation just yesterday, where all of our

hospitals get on a call each day and we try to load-level and
make sure that we can transfer patients. One small critical
access hospital, they jumped in as all of our larger tertiary
hospitals were saying that their ICUs were completely full and
they couldn't take transfers.

And this tiny hospital just said we just had a COVID patient pass
away in our ICU. We will have an ICU available in about 30
 minutes to try to off-load some of the pressure on these larger
hospitals that have just been inundated and in some cases are
on divert.

So, if you did need to go to an ICU, that might be closed, and

they might have to send you to the next closest ICU.
 William Brangham:
Are hospitals there at the point where they might have to choose
a ventilator goes to this patient and perhaps not that patient?
 Brian Whitlock:
William, those are difficult conversations to have, but they are
taking place.

If you have somebody in an ICU that's been on a ventilator for a

couple of weeks and is not showing any sign of improvement,
and you do have somebody who it might be younger whose
conditions may not be as acute as that person that's been in the
ICU for a couple of weeks, those are conversations that are
taking place about moving that one patient into comfort care and
freeing up the ventilator in order to hopefully save the life of
another patient.
 William Brangham:
Are these patients that are filling these ICUs unvaccinated
patients, by and large?
 Brian Whitlock:
More than by and large. Almost all of the patients that we are
seeing in the hospital and certainly in the ICU are unvaccinated.

We do see some vaccinated people with breakthrough cases

that do need hospitalization, but it's nowhere near as serious as
it would be if they were unvaccinated.
 William Brangham:
 I mean, that's got to be incredibly dispiriting for hospital staffs to
know 95 percent of the patients could have avoided this with a
free, safe vaccine.
 Brian Whitlock:
And that's the challenge.

Our nurses and our doctors and all our hospital personnel are
going to continue to be passionate and provide that
compassionate care. But there is some fatigue, knowing this is
entirely preventable, when you have a hospital that has 200 beds
in North Idaho, and more than 100 of those beds are taken up
with COVID patients that didn't need to be there. It could have
been prevented.

And yet you still have people who have other conditions, heart
attacks, breast cancer. I mean, there are other things that — you
mentioned elective surgeries have been canceled, but now some
of the urgent surgeries are also being postponed because those
hospital beds are being taken up by COVID patients who are
unvaccinated.
 William Brangham: